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30 DISTANT VISION AT 6 METRES – Each eye to be examined separately, then both eyes together. First without
correction, then with spectacles (if used) and lastly with contact lenses, if used. Record visual acuity in appropriate boxes.
Visual acuity to be tested at 6 metres. If a different distance is used the appropriate chart for the distance must be used. An
accurate eye to chart distance must be assured.
31 INTERMEDIATE VISION AT 1 METRE – Each eye to be examined separately and then both together. First without
correction, then with spectacles if used and lastly with contact lenses if used. Record visual acuity in appropriate boxes as
ability to read N14 at 100 cm.
32 NEAR VISION AT 30–50 CMS. – Each eye to be examined separately and then both together. First without
correction, then with spectacles, if used, and lastly with contact lenses, if used. Record visual acuity in appropriate boxes as
ability to read N5 at 30–50 cm.
Note: Bifocal contact lenses and contact lenses correcting for near vision only are not acceptable.
33 SPECTACLES – Tick appropriate box signifying if spectacles are or are not worn by applicant. If used, state
whether unifocal, bifocal, varifocal or “look-over”.
34 CONTACT LENSES – Tick appropriate box signifying if contact lenses are or are not worn. If worn, state type from
the following list; hard, soft, gas-permeable or disposable.
35 COLOUR PERCEPTION – If required, tick appropriate box signifying if colour perception is normal or not. State
which test is used e.g. Ishihara 24 plate. If abnormal, state number of plates read incorrectly.
40 HEARING – Tick appropriate box to indicate hearing ability as tested separately in each ear at 2 m. The applicant
should not be able to observe the examiner’s lips.
41 AUDIOMETRY – If pure-tone audiometry is required, the frequencies from 125 to 8,000 Hz should be measured and
the audiometric results recorded in an audiogram. The full range of frequencies has diagnostic value and is useful for
provision of advice concerning hearing conservation. Even so, only the frequencies 500, 1,000, 2,000 and 3,000 Hz need to
be recorded on the examination form.
50 URINALYSIS – State whether result of urinalysis is normal or not by ticking appropriate box. If no abnormal
constituents are present, state NIL in each appropriate box.
60 MENTAL HEALTH ASPECTS OF MEDICAL FITNESS DISCUSSED – Applicants should be asked about their
mental health and if they have any concerns about this aspect of their medical fitness. Mental health aspects refer to
conditions such as depression and anxiety. Questions based on those that have been validated in primary heath care
settings should be used where possible e.g concerning depression. Fatigue related issues can also be addressed in this
part of the examination. Medical examiners should be conversant with the causes, prevention and treatment of fatigue,
especially those related to sleep apnoea and/or which require medication to be alleviated. It is not required that the contents
of such discussions are recorded unless they impact on the Medical Assessment (see Manual of Civil Aviation Medicine for
guidelines)
61 BEHAVIOURAL ASPECTS OF MEDICAL FITNESS DISCUSSED - Applicants should be asked about behavioural
aspects related to their health and if they have any concerns about this aspect of their medical fitness. Behavioural aspects
refer to such behaviours as problematic use of substances. Questions based on those that have been validated in primary
heath care settings should be used where possible e.g concerning alcohol use. It is not required that the contents of such
discussions are recorded unless they impact on the Medical Assessment (see Manual of Civil Aviation Medicine for
guidelines).
62 PHYSICAL ASPECTS OF MEDICAL FITNESS DISCUSSED - Applicants should be asked about physical aspects of
their health and if they have any concerns about this aspect of their medical fitness. Questions concerning physical
exercise, weight, diet, smoking etc can be covered in this portion of the medical examination. Examiners should be aware of
standard preventive guidelines concerning common physical diseases and provide such advice as appropriate. Since
gastrointestinal upset is a common cause of in-flight incapacitation, advice concerning healthy eating habits, especially when
abroad, may usefully be given in this section. It is not required that the contents of such discussions are recorded unless
they impact on the Medical Assessment.
63 PREVENTIVE HEALTH ADVICE GIVEN - The goal of items 60 63 is to address adverse aspects of mental,
behavioural and physical health that are amenable to prevention. State whether or not preventive advice has been given by
　
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